Struck by Lightning: Bolt from Above Blinds Woman in One Eye

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Being struck by lightning is a rare event, and it can have some
equally unusual medical effects.

For one 77-year-old woman who survived being hit by an indirect
lightning strike while sitting in her car, those effects
included losing her vision in one eye, according to a new report
of her case.

An exam revealed that the strike tore a tiny hole in the woman's
macula, which is the part of the
eye that is critical for high-acuity vision.

The woman's case reveals the importance of checking the vision of
anyone who is struck by a bolt, researchers said in their report,
published March 31 in the journal BMJ Case Reports. [ 16
Oddest Medical Cases ]

"In the future, if patients are struck by lightning, it should be
a routine process to refer them to an ophthalmologist to have an
eye assessment," said study co-author Dr. Permesh Dhillon, an
ophthalmologist at Pilgrim Hospital in Boston, England.

The woman's injury wasn't diagnosed right away. When the
lightning bolt
struck the woman's car, she suffered some back pain, and her
hairdresser later noticed minor burns on the woman's scalp. Later
that day, the woman reported, the vision in her right eye was
blurred, and she could barely see with that eye, though it was
not painful, Dhillon said.

A few days later, when the woman visited her optician, she was
referred to Dhillon and his colleagues, who scanned the patient's
retina using a relatively new technique known as optical
coherence tomography (OCT). They found the hole in the woman's
macula, a part of the retina that is responsible for about 90
percent of vision, Dhillon said.

The retina doesn't conduct electricity very well, which suggests
the injury may have been caused by heat that was produced when
the lightning struck, he added.

Dhillon prescribed nonsteroidal anti-inflammatory eye drops, but
the woman stopped using them when she developed an allergic
reaction to the medication. After two months, the woman's vision
had not improved, and so she underwent surgery to correct the
hole in her macula. The surgery involves removing the jelly part
of the eye in contact with the retina, and injecting a gas bubble
to push the layer at the back of the eye back together, Dhillon
explained.

Lightning
strikes are extremely rare (though more common in tropical
regions). In the United States, an average of 51 people were
killed by lightning per year between 1984 and 2013, according to
the National Weather Service. Only about 10 percent of those
struck by lightning are killed.

There have been reports of lightning strikes affecting other
parts of the eyes, resulting in cataracts, burns or swelling, or
bleeding in a jellylike part of the eye called the vitreous
humour, Dhillon said. But "this lady was quite fortunate in that
only her retina was affected, and only in one eye," he said.